Chinese Association for the Study of Pain: Expert consensus on chronic postsurgical pain

Table 4 Division and cooperation between surgeons, anesthesiologists and pain physicians

Division and cooperation between surgeons, anesthesiologists and pain physicians
Surgeon	(1) Optimize surgical methods based on the principle of minimizing tissue trauma; (2) Communicate with the anesthesiologist before surgery to negotiate the best anesthesia plan; and (3) Provide preventive medication and necessary psychological intervention for patients at high risk of CPSP
Anesthesiologist	(1) Carefully evaluate the patient’s medical history, including chronic pain, opioid use, drug abuse and mental illness. Screen for patients at high risk of CPSP; (2) Educate patients and their families. Inform them about the possible challenges of perioperative analgesia and the risks of CPSP; (3) Communicate with the surgeon before the operation to understand the surgical method and discuss the best anesthesia plan; (4) Establish perioperative pain management files; (5) Based on a comprehensive assessment of the patient’s condition, an individualized multimodal analgesic plan is formulated; (6) Carefully evaluate and record the analgesic effect on the patient; (7) If the patient does not have good postoperative analgesia and uses high-dose opioids, the pain management file should be transferred to the pain physician 1 wk after the operation; and (8) Based on the follow-up results and the latest progress on research, continue to summarize and optimize the analgesia schemes for different surgical operations
Pain physician	(1) Review the perioperative pain management files after taking over the patient; (2) Carefully analyze the nature and source of pain and develop a corresponding treatment plan; (3) Establish a follow-up mechanism; (4) If CPSP occurs, provide pain management in time; and (5) Regularly discuss difficult cases of CPSP with surgeons and anesthesiologists. Summarize risk factors and feedback treatment effect. Discuss further optimization of perioperative analgesia plan and preventive measures

CPSP: Chronic post-surgical pain.